Vaginismus. 20 question – 20 answer

Vaginismus means the spasms of muscles in the outer part of the female genital area which makes it very difficult or impossible to have sexual intercourse.

Question 2: What are the symptoms of vaginismus?

The first symptoms of vaginismus are the spasms in genitals. Furthermore, most women start feeling fear of bleeding, tears, severe pain, the notion that their insides will be torn, a dread of death and so on during sexual intercourse.

Question 3: Can Vaginismus go away on its own?

In rare cases, it can. However, the vast majority do not achieve any progress despite waiting for many years.

Question 4: Will Vaginismus go away with woman’s own volition and if she tries to control the contraction of her muscles?

No. The will of the person won’t play a role because the muscle spasms are involuntary and can not be controlled so willpower will have no say in this.

Question 5: Will surgical removal of the hymen cure vaginismus?

No. There is no connection between the hymen and vaginismus. Elimination of hymen can only be a waste of time and money. Also, you cannot ignore the trauma it will cause to the patient.

Question 6: Are vaginismus and fear of sex the same thing?

Sometimes they are both observable at the same time. Most of the women who suffer from vaginismus may also experience fear of sex as well as muscle spasms. However, some women will just have a fear of sex without any muscle spasms. These women can’t have sex not because they have spasms; rather, they are frightened of sexual intercourse that prevents them. Which is quite the opposite in those women who suffer from vaginismus. They don’t have fear of sex but spasms make it impossible nevertheless.

Question 7: What are the differences between vaginismus and sexual reluctance?

Women who suffer from vaginismus still have sexual desires and are willing to have sex. They get aroused and enjoy it. Without sexual intercourse, they can orgasm by rubbing themselves. However, in long term vaginismus; which happens when the couples refuse to seek medical attention and after a number of failed attempts to have sex, they experience deep dissatisfaction and decrease in desire for sex which in its own turn results in avoiding sex altogether.

Question 8: Is intercourse possible while on sedative drugs or alcohol?

No. Alcoholic beverages or other means can help the person feel comfortable, but will not affect the spasms. Since there are contractions, sexual intercourse will not be possible.

Question 9: Will painkillers and desensitizing gel be useful?

No. It is not the pain that makes sexual intercourse impossible, but the muscle contractions.

Question 10: Does sexual intercourse in doctor’s presence that involves use of hot water, painkillers and anesthetic gel (all at the same time) as well as giving the man erectile stimulants have any clinical effect?

No. Although these patients may be able to have sexual intercourse in a doctor’s presence or with the help of drugs, later sexual intercourse problems will continue.

Question 11: Some doctors say that they can treat vaginismus in 1-3 sessions, is it possible?

No. Couple can’t get over vaginismus this way. If a couple was able to have sexual intercourse after just a few sessions, they most certainly had fear of sex, not vaginismus. Vaginismus and spasms won’t go away with this method.

Question 12: In terms of medical ethics, is it acceptable to have sexual intercourse with a doctor’s help or in their cabinet?

No. It’s neither medical nor ethical. But also it is not an approach to the patient’s benefit. Even if the couple was able to have sexual intercourse in a stranger’s presence, in future they will have deep regrets about the incident, feel guilt and embarrassment which in turn will result in accusing and feeling anger with each other for allowing such a thing happen.

Question 13: How should vaginismus be treated?

Today’s most effective treatment for vaginismus is sex therapy.

Question 14: What is the duration of this treatment?

Weekly therapy sessions may take up to 8 weeks or more.

Question 15: What is the success rate of treatment?

The percentage of success with sex therapy is 100%.

Question 16: Is success rate of treatment lower in the long term vaginismus?

No. Couples who have suffered from vaginismus for 15, 20, 25 years are treated successfully.

Question 17: In what terms the chance of recovery is low?

If the feelings between couples aren’t strong enough; if there is a conflict between them; if they have experienced serious sexual traumas in the past; In the case when one of the couples refuses to come to therapy the course of treatment will be difficult. Without support and cooperation of both sides, sexual therapy alone is not enough.

Question 18: Is therapy still possible despite these difficult situations mentioned in the previous question?

Of course, it is. However, couples may need family therapy or individual psychotherapy before taking sexual therapy.

Question 19: Should both of a couple participate in therapy for vaginismus?

Yes. This is a must. Often, men can think that “problem is in my partner, why do I need to be in sessions?”. However, the therapy requires both of the sides to participate in some tasks. Additionally, men’s behaviors toward their ladies affect the therapy process immensely. During sessions, we also inform men what is the right approach and how should or shouldn’t they treat their partners.

Question 20: Can sexual therapy be conducted by any psychiatrist or psychologist?

As sexual therapy is a special practice, a psychiatrist and/or psychologist must be certified before practicing this kind of therapy. Having a psychotherapy degree; especially in cognitive-behavioral therapy, the therapist earns a ticket to train in the sex therapy field. The ones without a degree or experience in this field shouldn’t be working with psychogenic sexual dysfunctions.